If you’ve been following along, you’re aware that I’m parenting an 8-year-old little girl who experiences the world through the Autism Spectrum. Unlike what tends to be shown in media, she’s both quite verbal and social. At this point, she’s what’s considered “High Functioning” because she has a higher cognitive capacity and isn’t as limited in how she interacts with the world at large. That being said, there are still many challenges.
She’s a sensation seeker AND has sensory processing issues. (For more detailed information, please read this article, Sensory Issues: Seeking and Avoiding.) She also has many social interaction challenges, especially with her peers. A lot of these challenges are interrelated. Here’s a list of the issues we are dealing with at school and at home:
- Climbing the furniture: This isn’t just the kind of climbing that other children may do and get into trouble for. When they get in trouble and experience consequences, they tend to learn to avoid the behavior, especially in the presence of those who administer the consequences. With her, it’s constant. It doesn’t matter how much she’s been told not to or what consequences she’s experienced. It simply is something she’s completely compelled to do and does it without compunction or inhibition.
- Pouncing: There is no concept of personal space or comprehension of where she ends and anyone else begins. I’m a regular target. My lower back will never be the same. God save the cats at her dad’s. Since they’re much smaller than she is and they tend to do what cats do and sleep a lot, she not only pounces on them, she chases, grabs, and has even been known to hit and kick them when they don’t receive her attentions and affections the way she wants them to. Which brings me to:
- Violence: When she becomes mentally or emotionally overwhelmed, and it’s not always easy to see the direct trigger, she will become verbally/emotionally abusive and even physically violent, attacking anyone in her vicinity who has committed whatever offense she is experiencing inside of her head. It can easily be triggered by. . .
- Transitions: Moving from one activity to another, switching from one environment to another, dealing with changes in personnel or people involved in her life, are all potential triggers for resistance, violence, and sensation seeking behaviors.
Other things she does are things like “minor” self harm behaviors, hitting herself on the forehead with the base of her palm, chewing her toenails, running herself into walls, as well as constant walking on her tiptoes and arm flapping.
She is almost always laughing when she does any of the behaviors which negatively impact the people around her. Her ability to read and reasonably respond to social cues is virtually non-existent. She seems to have selective hearing, in the sense that people often speak to her and try to get her attention, but she continues to stay hyper focused on whatever it is that she’s doing and has no reaction. Conversely, she is a chatterbox about the things she’s interested in and has little to no ability to pause in her monologue and respond appropriately to what others are saying during the interactions.
Morning and nighttime routines with me are very problematic. Every transition is a battle.
I’m overwhelmed and, more times than I care to admit, can become discouraged and just not do whatever the thing is that needs doing because I don’t have the mental capacity or physical energy to fight the battle. Therefore, her negative behaviors are positively reinforced because she gets her way and I know I’ve done the wrong thing for the sake of temporary peace.
There is a form of therapy that has been shown to be very helpful and effective for people “on the spectrum.” It’s called ABA Therapy: Applied Behavior Analysis. It examines the interactions and behaviors, breaking them down in a way that identifies what the triggers are. Then, there are structured interventions established in step by step increments, with what I as her parent need to do.
Again, this may seem like something that neurotypical children and their parents do when there needs to be changes made to improve parent-child interactions and redirect children into more constructive and positive behavior. However, this is more about teaching situational responses in an habitual way. There is very little ability to “transfer” and “translate” from one situation to another, sometimes from one moment to another. Cause and effect are almost completely disconnected. Metaphor and simile are lost on her. Therefore, she can’t see how one situation is similar to another and figure out that she can apply the same reasoning to the new situation to get a similar outcome or understand that the same behavior in a different situation is going to get the same reaction.
We have an ABA Consultant through her DHS Developmental Disability Services Program. However, they’re only approved for 12 hours per service YEAR! I recently found out that there’s a company that can bill the Oregon Health Plan to come into our home and do pretty much full-time therapy and support to train and support me in how to work with her and to help her get into the structure she needs.
The glitch is that I never got a MEDICAL identification of the autism. There is an Educational identification in order to qualify her for educational support services. There was the evaluation to determine if she qualifies for the DDS program. However, it also was not a medical evaluation, just a psychological evaluation. Her pediatrician can’t do the medical evaluation. It has to be refered to a psychiatrist for a psychiatric diagnosis, since that’s the only qualified way of getting a medical identification/diagnosis.
Going the route of the referral from the pediatrician can take 3-12 months or more.
Thankfully, since she’s been seeing a mental health therapist for over a year now through the same organization, they have referred her to be evaluated by their Psychiatric Nurse Practitioner. She has her eval in two and a half weeks. We’ve been waiting about 6 weeks or so.